Trends and serotype distribution of human Salmonella strains in central Italy (2015-2021)

Abstract Introduction Salmonella enterica (S.) is one of the most common agents of foodborne infections and a risk for children, elder people and immunocompromised patients. S. is the first cause of foodborne outbreaks in the EU, the majority being caused by S. Enteritidis. We report S. serovars prevalence and trends in clinical isolates in central Italy from 2015 to 2021. Methods S. strains of patients from Lazio and Tuscany regions isolated by hospitals and private laboratories were sent to the Regional Reference Centre for Pathogenic Enterobacteria (CREP) at IZSLT (Rome) for serotyping. All metadata and a selection of isolates were shared with ISS according to the National Surveillance Enter-Net Italia program. Results A total of 2395 strains were collected from 2015 to 2021, with a mean value of 342 strains per year. Notably, reported cases did not decrease during the pandemic in 2020. A total of 116 different serovars were identified. The most common ones were S. Typhimurium var. monophasic, which increased from 2015 to 2021, S. Enteritidis, which peaked in 2018 doubling its average, and S. Typhimurium with a reverse trend compared to the monophasic variant, followed by S. Infantis, S. Napoli and S. Derby. Afterwards, S. Brandenburg showed a constant increase (from 2 cases in 2015 to 18 cases in 2021). S. Strathcona showed a significant peak during 2019 with 23 cases, correlated to a European reported outbreak. The average age of patients was stable (mean 28.5, median 12.8), except for an increase in 2021 (mean 35.2, median 27). Conclusions The results show a substantial agreement between data collected in central Italy and national trends. The occurrence of cases per year is stable. The serovars prevalence does not agree with the prevalence found in EU, in particular concerning S. Typhimurium var. monophasic frequency. Further investigations are needed to explain the significant increment of patients’ mean age in 2021. Key messages This kind of studies provide a detailed picture of the S. serotypes actually relevant to human health and could be used to improve and update food safety regulations and monitoring programs. Surveillance and digital reporting, even retrospective, are pivotal tool for long-term monitoring, outbreaks investigation and research.


Background:
Adolescents playing sport are more likely to reach the recommended levels of physical activity. In 2001In , 2006In , 2011 and 2019, four successive French national plans were launched to ''develop physical and sports activity and limit sedentary living''. Monitoring sport participation rates (SPR) is one of the essential components to evaluate these plans. To date, information on temporal trends in SPR has mainly come from the national population. However, due to sample size, it was impossible to measure trends among adolescents on the territory level. Given the various economic and geographical disparities between territories, it is likely that territory specific trends exist. The main objective of this study was to measure temporal trends in adolescent SPR in the third biggest French department (South-East of France).

Methods:
Four retrospective studies were conducted in high-schools between March and April 2001, 2008, 2015and 2019. A quota sampling design was used to obtain geographically and socially representative samples. They were invited to report their sex, their socioeconomic status (SES) and their sport participation. A sports player was defined as an adolescent playing sport for at least one hour a week. SPR were calculated by sex and SES with 95% confidence interval (95% CI).

Conclusions:
Temporal trends in adolescent SPR in this territory are in decline since 2001. Governmental plans to improve SPR seems to have had a limited success in this territory. Key messages: Weekly sport participation is declining among adolescents in the South-East of France. Social inequality in weekly sport participation are increasing over time.

Conclusions:
The results show a substantial agreement between data collected in central Italy and national trends. The occurrence of cases per year is stable. The serovars prevalence does not agree with the prevalence found in EU, in particular

Background:
The COVID-19 pandemic had a significant impact on economic development, lifestyles and health systems in all countries. Due to the lack of medical interventions, many countries adopted restrictive measures to slow the spread of the virus and reduce the burden on the healthcare system. Quarantine measures have had an impact on the transmission of SARS-CoV-2. However, the unintended consequences of such drastic measures were inevitable. In developing countries, there have been adverse effects of disruptions in health services, including the provision of timely medical services in detecting cases of tuberculosis in the population. The aim of this study was to study the influence of COVID-19 pandemic on the tuberculosis incidence in the Republic of Kazakhstan.

Methods:
We analyzed national data on the reported tuberculosis cases and screening results of tuberculosis in Kazakhstan for 2019-2020. The primary data were collected from regular reporting of cases through surveillance.

Results:
The number of registered patients identified during screening activities in 2020 were 2,854 cases compared to 4,288 cases in 2019 before COVID-19 era. The proportion of cases with antibiotic-resistant (poly, multi, super) forms of tuberculosis increased up to 6.7% in 2020 in comparison with 2019.

Conclusions:
There is a need to conduct an analysis of the reasons for the increase in cases of multidrug-resistant and extensively drugresistant tuberculosis. The working process should be adapted to epidemics and emergencies to ensure the availability of medical services, as well as to improve the system of preventive examinations and screening for the early detection of TB cases. The abstract was submitted under the 'CATINCA -Capacities and infrastructures for health policy development' project which is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe.

Key messages:
The detection of tuberculosis during preventive examinations and screenings significantly decreased in 2020 compared to 2019. In recent years, there has been a significant increase in the number of cases with poly-, multi-and superantibioticresistant forms of tuberculosis.

Background:
Musculoskeletal and connective tissue diseases represent a growing public health problem, a great burden on health systems and place a heavy burden on society as a whole. Patients with musculoskeletal and connective tissue diseases often retire early, and any early retirement that could be prevented represents a loss of human capital, which means great social and economic damage to society. The present study was conducted in order to calculate for the first time in Slovenia the costs of the six most common diseases of the musculoskeletal and connective tissue diseases for the period from 2016-2018.

Methods:
The calculated burden of musculoskeletal and connective tissue diseases was based on the calculation of various direct and indirect costs cross-sectionally at the level of one year. The methodology of National Transfer Accounts (NTA) was used for the calculation of indirect costs. Six major diagnoses based on the International Classification of Diseases and Related Health Problems for statistical purposes were selected for calculation. Data were obtained from different national routine databases.

Results:
Calculations of the economic burden of musculoskeletal and connective tissue diseases in Slovenia showed that the economic costs of six selected diagnoses in the period 2016-2018 averaged about 5% of total health expenditure or 0.4% of gross domestic product in this period. The highest direct costs were hospitalizations, followed by costs for medicines, first curative visits at the primary level and visits to the outpatient clinic at the secondary level.

Conclusions:
The results of the first calculation of the burden of musculoskeletal and connective tissue diseases in Slovenia showed a high economic burden of these diseases in the period from 2016 to 2018. The economic burden is underestimated and would be significantly higher considering all diagnoses from this group of diseases. Key messages: Reducing the burden of musculoskeletal and connective tissue diseases is absolutely necessary in view of the aging population and in the light of the sustainability of health systems. The preparation of strategic documents for the promotion of musculoskeletal health and the consistent implementation of their contents has become urgent in Slovenia.